ELLIOTT JAY WAGNER

NEW YORK, NY
NPI1558312579
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2085R0202X Radiology, Diagnostic Radiology
(Licence: CA  G49698)
Additional Taxonomies2085R0202X Radiology, Diagnostic Radiology
(Licence: NY  238657-1)
2085R0202X Radiology, Diagnostic Radiology
(Licence: NJ  25MA08122100)
2085R0202X Radiology, Diagnostic Radiology
(Licence: NM  MD2008-0777)
Enumeration Date2006-05-15
Last Update Date2024-05-22
Business Address
ELLIOTT JAY WAGNER M.D.
200 E 66TH ST APT C904
NEW YORK, NY 10065-0163
Phone number: 949-378-4889
Mailing Address
ELLIOTT JAY WAGNER M.D.
200 EAST 66TH ST C904
NEW YORK, NY 10065-9175
Phone number: 888-886-5238